Brief Answer:
Need some more information on your symptoms.

Detailed Answer:
Hi, thanks for writing to XXXXXXX

I need some more information with regard to your symptoms to arrive at a possible diagnosis.
- Exact location of the pain in the leg
- whether pain is present in one leg or both legs
- whether in the front or back of leg
- Is the pain present continuously throughout the day
- What factors aggravate your pain & what activities provide relief
- nature of pain - burning, stabbling, throbbing
- any associated medical conditions like hypertension, diabetes, thyroid etc
- any intake of medicines for other ailments

Please answer the above queries in an elaborate manner as far as possible.

Regards

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Brief Answer:
Might be due to Arthritis.

Detailed Answer:
Hi, Nice to hear from you.

Based on the answers provided by you, I suspect that the cause of pain may be due to Ankle or Subtalar (joint below the ankle) arthritis (wear & tear in the joints) .

The points that go infavour of this condition are
- Long history of symptomatology
- Stiffness in the morning hours
- Increased pain while walking after a period of rest
- Getting relief with massage & Ice
- Over weight is an aggravating factor for lower leg arthritis

This condition can be diagnosed by having Xrays of the involved joints (typical views to evaluate the subtalar joint).

CT or MRI scan may be needed in rare cases, when the xrays are negative for any abnormality.

The conservative management of this condition is as follows -

- Activity Modification: Limiting standing and walking particularly on uneven terrain will help limit exacerbation of symptoms from subtalar arthritis. Use of an exercise bike of swimming as a form of aerobic exercise instead of walking or running will likely be beneficial as it allows for a good workout with much less loading through the subtalar joint.
- Weight-Loss: The back part of the foot is subject to forces equivalent to 3-5x body weight during daily activities so losing even a moderate amount of weight can substantially decrease the forces going through the arthritic joint.
- Comfort Shoes: Use of comfort shoes including adding a shock absorber in the heal can help decrease the repetitive loading through the subtalar joint.
- Ankle Bracing: Use of an ankle brace such as an ankle lacer or even taping the ankle and hindfoot can be helpful because it serves to limit motion through the arthritic subtalar joint.
- Icing and Elevation after Activity: Elevating the leg and placing a bag of ice around the ankle and hindfoot after activity can help to decrease pain and swelling. Ice should only be applied for 10-15 minutes at a time.
- Analgesics: Plain Tylenol (acetaminophen) taken 2-3 times a day can help reduce the pain from subtalar arthritis. It may not be as effective as anti-inflammatory medications (NSAIDs) but it works via a different mechanism so it may have an additive effect.
- Glucosamine Sulfate: Although it has not been shown to be beneficial in long-term studies many people report improved symptom control when they take glucosamine sulfate. It needs to be taken daily for 6-8 week for any benefit to be seen.
- Strengthening and stretching programs: Exercise to keep the muscles of the foot as strong as possible and to keep the joint moving through a gentle range of motion may be helpful.

Hope this information is helpful. Happy to help further

Regards

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Brief Answer:
Please do follow the recommendations.

Detailed Answer:
Hi, Nice to hear from you.

Thanks for the appraisal.

Wishing you a faster recovery & good health.

Have a great day

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